脊髓髓内胶质瘤的显微外科手术治疗(附42例临床分析)

目的：分析和评价脊髓内胶质瘤显微外科手术的疗效和预后。方法：回顾性分析显微外科手术治疗脊髓髓内胶质瘤42例的结果。结果：22例室管膜瘤中全切除19例（86．4％），20例星形细胞瘤全切除9例（45．0％），全组无手术死亡。32例随访3个月至5．5年（平均31个月）。最后一次随访结束时（失访按出院前的神经功能评定）；肌力改善15例（35．7％），不变21例（50．0％），加重5例（11．9％）。结论：室管膜瘤应力争一期全切除，星形细胞瘤不应强调全切除而以手术减压为主。显微神经外科技术可改善脊髓髓内肿瘤的预后。

Microsurgical treatment of intramedullary spinal cord gliomas: an analysis of 42 cases

Objective: : To evaluate the results of microsurgi ca l management for intramedullary spinal cord gliomas. Methods: Fo rty two patients received microsurgical resection for intramedullary spinal cor d glioma were studied retrospectively. Results: Of 22 cases with intramedullary ependymoma, complete removal was achieved in 19 patients. Of 20 cases with intramedullary astrocytoma, complete removal was achieved in 9 patien ts. There were no deaths due to surgery. Thirty two patients were followed up for 3 months to 66 months with an average of 31 months. When comparing the preop erative and follow up functional grades, 50.0% remained the same, 35.7% improve d, and 11.9% deteriorated. Conclusion: Intramedullary ependymoma s should be totally resected, while a constrainedly complete resection is not ne cessary for an intraspinal astrocytoma.